Canadian Journal of Public Health

, Volume 99, Issue 2, pp 102–106 | Cite as

Neonatal Vitamin A Deficiency and Its Impact on Acute Respiratory Infections among Preschool Inuit Children

  • Cynthia Cameron
  • Frédéric Dallaire
  • Carole Vézina
  • Gina Muckle
  • Suzanne Bruneau
  • Pierre Ayotte
  • Eric DewaillyEmail author



To assess if vitamin A concentration in umbilical cord blood is associated with incidence and severity of respiratory infections in preschool Inuit children from Nunavik (Québec, Canada).


The medical charts of 305 children were reviewed from 0 to 5 years of age. The association between vitamin A concentration in umbilical cord plasma and the incidence rates of acute otitis media (AOM), lower respiratory tract infections (LRTIs) and hospitalization rates for LRTIs was evaluated using Poisson regression.


Compared to children with vitamin A concentration >-20 μg/dl, adjusted rate ratios (RR) for children below 20 μg/dl ranged between 1.06–1.62 for AOM, 1.12–1.34 for LRTIs, and 1.09–1.43 for hospitalization for LRTIs. Most RRs were statistically significant for AOM and LRTIs, but not for hospitalization for LRTIs.


Neonatal vitamin A deficiency appears to be a significant risk factor for AOM and LRTIs in this population.

Key words

Vitamin A deficiency Inuits nutritional status respiratory tract infections otitis media infant child risk factor 



Évaluer si la concentration de vitamine A dans le sang de cordon ombilical est associée avec l’incidence et la sévérité des infections respiratoires chez les enfants inuits d’âge préscolaire au Nunavik (Québec, Canada).


Les dossiers médicaux couvrant les 5 premières années de vie de 305 enfants ont été examinés. L’association entre la concentration de vitamine A dans le sang de cordon ombilical et ‘incidence d’otite moyenne aiguë (OMA), d’infections des voies respiratoires inférieures (IVRI) et d’hospitalisations pour des IVRI a été évaluée à l’aide du modèle de régression de Poisson.


Comparativement aux enfants ayant des concentrations de vitamine A >-20 μg/dL, les taux d’incidences relatifs ajustés (TR) des enfants avec des concentrations <20 μg/dL étaient compris entre 1,06 et 1,62 pour les OMA, entre 1,1 2 et 1,34 pour les IVRI et entre 1,09 et 1,43 pour les hospitalisations pour IVRI. La plupart des TR étaient statistiquement significatifs pour les OMA et les IVRI, mais pas pour les hospitalisations.


Une déficience néonatale en vitamine A semble être un facteur de risque significatif d’OMA et d’IVRI dans cette population.

Mots clés

déficience en vitamine A Inuit statut nutritionnel infection des voies respiratoires otite moyenne aiguë nourrisson enfant facteur de risque 


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  1. 1.
    Sommer A. Vitamin A deficiency, child health, and survival. Nutrition 1997;13(5):484–85.PubMedCrossRefGoogle Scholar
  2. 2.
    West KP, Jr., Howard GR, Sommer A. Vitamin A and infection: Public health implications. Annu Rev Nutr 1989;9:63–86.PubMedCrossRefGoogle Scholar
  3. 3.
    Kapil U, Bhavna A. Adverse effects of poor micronutrient status during childhood and adolescence. Nutr Rev 2002;60(5 Pt 2):S84–90.PubMedCrossRefGoogle Scholar
  4. 4.
    Bhaskaram P. Micronutrient malnutrition, infection, and immunity: An overview. Nutr Rev 2002;60(5 Pt 2):S40–45.PubMedCrossRefGoogle Scholar
  5. 5.
    Semba RD. Vitamin A, immunity, and infection. Clin Infect Dis 1994;19(3):489–99.PubMedCrossRefGoogle Scholar
  6. 6.
    Ross AC. The relationship between immunocompetence and vitamin A status. In: Sommer A, West KP (Eds.), Vitamin A Deficiency: Health, Survival, and Vision. New York: Oxford University Press, 1996;251–73.Google Scholar
  7. 7.
    Ross AC, Stephensen CB. Vitamin A and retinoids in antiviral responses. Faseb J 1996;10(9):979–85.PubMedCrossRefGoogle Scholar
  8. 8.
    Basu S, Sengupta B, Paladhi PK. Single megadose vitamin A supplementation of Indian mothers and morbidity in breastfed young infants. Postgrad Med J 2003;79(933):397–402.PubMedPubMedCentralCrossRefGoogle Scholar
  9. 9.
    Sommer A, Katz J, Tarwotjo I. Increased risk of respiratory disease and diarrhea in children with preexisting mild vitamin A deficiency. Am J Clin Nutr 1984;40(5):1090–95.PubMedCrossRefGoogle Scholar
  10. 10.
    Bloem MW, Wedel M, Egger RJ, Speek AJ, Schrijver J, Saowakontha S, et al. Mild vitamin A deficiency and risk of respiratory tract diseases and diarrhea in preschool and school children in northeastern Thailand. Am J Epidemiol 1990;131(2):332–39.PubMedCrossRefGoogle Scholar
  11. 11.
    Dudley L, Hussey G, Huskissen J, Kessow G. Vitamin A status, other risk factors and acute respiratory infection morbidity in children. S Afir Med J 1997;87(1):65–70.Google Scholar
  12. 12.
    Pinnock CB, Douglas RM, Badcock NR. Vitamin A status in children who are prone to respiratory tract infections. Aust Paediatr J 1986;22(2):95–99.PubMedGoogle Scholar
  13. 13.
    Sommer A. Vitamin A status, resistance to infection, and childhood mortality. Ann N Y Acad Sci 1990;587:17–23.PubMedCrossRefGoogle Scholar
  14. 14.
    Dallaire F, Dewailly E, Shademani R, Laliberte C, Bruneau S, Rhainds M, et al. Vitamin A concentration in umbilical cord blood of infants from three separate regions of the province of Quebec (Canada). Can J Public Health 2003;94(5):386–90.PubMedGoogle Scholar
  15. 15.
    Sempertegui F, Estrella B, Camaniero V, Betancourt V, Izurieta R, Ortiz W, et al. The beneficial effects of weekly low-dose vitamin A supplementation on acute lower respiratory infections and diarrhea in Ecuadorian children. Pediatrics 1999;104(1):e1.PubMedCrossRefGoogle Scholar
  16. 16.
    Kartasasmita CB, Rosmayudi O, Deville W. Demedts M. Plasma retinol level, vitamin A supplementation and acute respiratory infections in children of 1–5 years old in a developing country. Respiratory Diseases Working Group. Tuber LungDis 1995;76(6):563–69.CrossRefGoogle Scholar
  17. 17.
    Barreto ML, Santos LM, Assis AM, Araujo MP, Farenzena GG, Santos PA, et al. Effect of vitamin A supplementation on diarrhoea and acute lower-respiratory-tract infections in young children in Brazil. Lancet 1994;344(8917):228–31.PubMedCrossRefGoogle Scholar
  18. 18.
    Venkatarao T, Ramakrishnan R, Nair NG, Radhakrishnan S, Sundaramoorthy L, Koya PK, et al. Effect of vitamin A supplementation to mother and infant on morbidity in infancy. Indian Pediatr 1996;33(4):279–86.PubMedGoogle Scholar
  19. 19.
    Biswas R, Biswas AB, Manna B, Bhattacharya SK, Dey R, Sarkar S. Effect of vitamin A supplementation on diarrhoea and acute respiratory tract infection in children. A double blind placebo controlled trial in a Calcutta slum community. Eur J Epidemiol 1994;10(1):57–61.PubMedCrossRefGoogle Scholar
  20. 20.
    Pandey A, Chakraborty AK. Undernutrition, vitamin A deficiency and ARI morbidity in underfives. Indian J Public Health 1996;40(1):13–16.PubMedGoogle Scholar
  21. 21.
    Durand AM, Sabino H, Jr., Masga R, Sabino M, Olopai F, Abraham I. Childhood vitamin A status and the risk of otitis media. Pediatr Infect Dis J 1997;16(10):952–54.PubMedCrossRefGoogle Scholar
  22. 22.
    Roy SK, Islam A, Molla A, Akramuzzaman SM, Jahan F, Fuchs G. Impact of a single megadose of vitamin A at delivery on breastmilk of mothers and morbidity of their infants. Eur J Clin Nutr 1997;51(5):302–7.PubMedCrossRefGoogle Scholar
  23. 23.
    Julien MR, Gomes A, Varandas L, Rodrigues P, Malveiro F, Aguiar P, et al. A randomized, double-blind, placebo-controlled clinical trial of vitamin A in Mozambican children hospitalized with nonmeasles acute lower respiratory tract infections. Trop Med Int Health 1999;4(12):794–800.PubMedCrossRefGoogle Scholar
  24. 24.
    Vinutha B, Mehta MN, Shanbag P. Vitamin A status of pregnant women and effect of post parturn vitamin A supplementation. Indian Pediatr 2000;37(11):1188–93.PubMedGoogle Scholar
  25. 25.
    Shirali GS, Oelberg DG, Mehta KP. Maternal-neonatal serum vitamin A concentrations. J Pediatr Gastroenterol Nutr 1989;9(1):62–66.PubMedCrossRefGoogle Scholar
  26. 26.
    Yeum KJ, Ferland G, Patry J, Russell RM. Relationship of plasma carotenoids, retinol and tocopherols in mothers and newborn infants. J Am CollNutr 1998;17(5):442–47.Google Scholar
  27. 27.
    Stoltzfus RJ. Vitamin A deficiency in the mother-infant dyad. SCN News 1994(11):25–27.Google Scholar

Copyright information

© The Canadian Public Health Association 2008

Authors and Affiliations

  • Cynthia Cameron
    • 1
  • Frédéric Dallaire
    • 2
  • Carole Vézina
    • 1
  • Gina Muckle
    • 1
  • Suzanne Bruneau
    • 1
  • Pierre Ayotte
    • 1
    • 2
  • Eric Dewailly
    • 1
    • 2
    Email author
  1. 1.Unité de recherche en santé publique, CHUL-CHUQQuebec CityCanada
  2. 2.Department of Social and Preventive Medicine, Faculty of MedicineLaval UniversityCanada

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